The black population is disproportionately affected by acquired immune deficiency syndrome (AIDS). Among those black people most at risk of becoming infected with the human immunodeficiency virus are black men who use intravenous drugs and black men who are gay. This article explores the complex cultural, economic, and social factors obstructing the reduction of the AIDS rate among these men. Implications and recommendations are made for developing effective AIDS prevention efforts by highlighting race-specific resources and supports for high-risk black men.